The influence of the French Communist Party on French foreign relations, 1934-1939.

http://www.archive.org/details/influenceoffrenc00fee

Low Cost Task Trainer for Neonatal Umbilical Catheterization

ABSTRACT: Audience: The low cost neonatal umbilical catheterization task trainer is designed to instruct physicians in pediatrics, emergency medicine (EM) and pediatric emergency medicine (PEM). Introduction: Umbilical catheterization can be a lifesaving technique in the emergent management of a critically ill neonate. Umbilical catheterization remains a common procedure in the neonatal intensive care unit (NICU) setting but is performed less frequently in the emergency department (ED). Given its infrequent nature in the ED, procedural simulation in umbilical catheterization is a necessary component of medical training to gain proficiency and competency in this important technique. Commercially available umbilical catheterization models are available but often represent an expensive investment upwards of a thousand dollars for a single trainer. The expense of these high-fidelity models may be unfortunately cost prohibitive for many departments seeking to offer this simulation training for their physicians. In an effort to diminish the cost associated with these models, a “home built” model was trialed. It was easily constructed with readily available items found in the hospital, the household setting, and the local home improvement and toy store. Each task trainer allows for identification of the umbilical arteries and vein with the ability to catheterize either vessel. Objectives: By the end of this instructional session learners should: 1) Discuss the indications, contraindications, and complications associated with umbilical catheterization. 2) Competently perform umbilical catheterization on the task trainer. 3) Demonstrate proper securement of the catheter. Methods: An umbilical cord was constructed using suction catheters to represent the umbilical arteries and nasal canula oxygen tubing was used to represent the umbilical vein. These tubes were suspended in a silicone base and rolled into a log form to simulate the umbilical cord. A small circular hole was cut into the hollow abdomen of a commercially available plastic toy doll and a section of the umbilical cord was inserted. Once assembled, the task trainer can be used in an instructional procedure session to teach umbilical vessel catheterization. The cord can be tied off and cut, allowing for identification of the umbilical vessels. The vessels (either artery or vein) can be cannulated using a variety of catheter sizes, and ultimately the catheter can be sutured or taped in place. The task trainers can be reused multiple times.Topics: Neonatal resuscitation, umbilical catheter, umbilical catheterization, umbilical cannulation, instruction, simulation, emergency medicine, pediatrics, neonatal

Low Cost Task Trainer for Neonatal Umbilical Catheterization

ABSTRACT: Audience: The low cost neonatal umbilical catheterization task trainer is designed to instruct physicians in pediatrics, emergency medicine (EM) and pediatric emergency medicine (PEM). Introduction: Umbilical catheterization can be a lifesaving technique in the emergent management of a critically ill neonate. Umbilical catheterization remains a common procedure in the neonatal intensive care unit (NICU) setting but is performed less frequently in the emergency department (ED). Given its infrequent nature in the ED, procedural simulation in umbilical catheterization is a necessary component of medical training to gain proficiency and competency in this important technique. Commercially available umbilical catheterization models are available but often represent an expensive investment upwards of a thousand dollars for a single trainer. The expense of these high-fidelity models may be unfortunately cost prohibitive for many departments seeking to offer this simulation training for their physicians. In an effort to diminish the cost associated with these models, a “home built” model was trialed. It was easily constructed with readily available items found in the hospital, the household setting, and the local home improvement and toy store. Each task trainer allows for identification of the umbilical arteries and vein with the ability to catheterize either vessel. Objectives: By the end of this instructional session learners should: 1) Discuss the indications, contraindications, and complications associated with umbilical catheterization. 2) Competently perform umbilical catheterization on the task trainer. 3) Demonstrate proper securement of the catheter. Methods: An umbilical cord was constructed using suction catheters to represent the umbilical arteries and nasal canula oxygen tubing was used to represent the umbilical vein. These tubes were suspended in a silicone base and rolled into a log form to simulate the umbilical cord. A small circular hole was cut into the hollow abdomen of a commercially available plastic toy doll and a section of the umbilical cord was inserted. Once assembled, the task trainer can be used in an instructional procedure session to teach umbilical vessel catheterization. The cord can be tied off and cut, allowing for identification of the umbilical vessels. The vessels (either artery or vein) can be cannulated using a variety of catheter sizes, and ultimately the catheter can be sutured or taped in place. The task trainers can be reused multiple times.Topics: Neonatal resuscitation, umbilical catheter, umbilical catheterization, umbilical cannulation, instruction, simulation, emergency medicine, pediatrics, neonatal

Two-photon adaptive optics fluorescence lifetime imaging ophthalmoscopy

Thesis (Ph. D.)--University of Rochester. The Institute of Optics, 2018.There are many critical processes involved in keeping the retina functioning properly. Two of these, the visual cycle and the metabolism of the cell, are tied together by their conversion of important molecules from one form to another. In the visual cycle, 11-cis-retinal is regenerated so that it can combine with a rhodopsin molecule and initiate phototransduction. In cellular metabolism, the cell undergoes many steps to generate adenosine triphosphate, the energy unit of the cell. These mechanisms are critical in maintaining a functioning retina, however they have been difficult to directly interrogate in the living eye. A technique which can quantitatively measure these processes could allow researchers and clinicians to examine them in healthy subjects and how they change under conditions of disease. The goal of this work is to develop a technique which will allow us to investigate these measures of retinal function quantitatively and in a repeatable way. Advantageously, molecules which are converted during the visual cycle or cellular metabolism are accessible using adaptive optics aided two-photon fluorescence ophthalmoscopy. Furthermore, I develop a new technique, adaptive optics fluorescence lifetime ophthalmoscopy, which provides a robust and quantitative measure of a key property of retinal fluorescence. Initially, this method was deployed in a new two-photon adaptive optics ophthalmoscope designed for imaging mice. Exogenous fluorophores with known fluorescence lifetimes were used to validate the initial measurements, before using the new technique to establish baseline measurements for a sensor of cellular metabolism in the mouse eye. Following successful implementation in the mouse, the fluorescence lifetime method was translated to a system dedicated to imaging the macaque retina. By measuring the fluorescence lifetime of endogenous fluorescence originating in the photoreceptors, I found that rods and cones exhibit different fluorescence lifetimes. Further development of this technology may advance research in widespread areas including fluorophore identification in the retina, mechanisms of retinal metabolism, and as a clinical diagnostic